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Abstract

Abdominal aortic calcification (AAC) appears earlier and in greater quantities than coronary artery calcification (CAC). Little comparative information is available about cardiovascular disease (CVD) risk factors for AAC and CAC. MESA is a multi-ethnic study of men and women aged 45– 84 years without known CVD at baseline. Traditional and novel CVD risk factors were assessed, and a random subset (n=1970) of participants had both AAC and CAC measured by CT. Since AAC and CAC were significantly correlated (r=0.38), four distinct groups were defined:

The table⇓ shows odds ratios for independent risk factors, with “no AAC or CAC” (n = 416) as the reference group. “AAC only” was independently associated with age, LDL-C, hypertension and lipid medications, and past and current smoking, and inversely with HDL-C and African-American and Hispanic ethnicity. By contrast, for “CAC only”, independent risk factors were limited to age and male gender. For “AAC and CAC”, the odds ratios showed results similar to “AAC only”, although consistently greater in magnitude because of the higher amounts of AAC in the “AAC and CAC” vs. the “AAC only” group. Multivariate regressions for continuous measures of AAC and CAC gave similar results. None of the multiple novel risk factors assessed, including inflammation factors, remained significant in multivariate analysis. In conclusion, standard, but not novel, CVD risk factors were strongly and independently linked to AAC, but not to CAC. Thus, AAC appears to reflect the calcified atherosclerotic burden from CVD risk factors much better than CAC. Future analyses will determine the relative predictive power of AAC vs. CAC for future CVD events.